Measuring heart and pulse rates in living subjects has become a valuable tool during physical exercise and for health monitoring. The heart rate and pulse rate of a subject are related. Heart rate may be defined as the number of heart contractions over a specific time period, usually defined in beats per minute. A pulse is defined as the rhythmical dilation of a vessel produced by the increased volume of blood forced through the vessel by the contraction of the heart. Since heart contractions normally produce a volume of blood that can be measured as a pulse, heart rate and pulse rate are ideally the same. However, a pulse rate may differ from the heart rate during irregular heart beats or premature heart beats. In this case, a heart contraction may not force enough blood through a blood vessel to be measured as a pulse.
A pulse rate is measured by counting the rate of pulsation of a subject's artery. The heart rate is measured by sensing the electrical activity of the heart based on electrocardiograms (for example EKG or ECG). Individuals who want to increase their endurance or performance may wish to exercise while maintaining target heart rates. Conversely, subjects with a history of heart disease or other heart related condition should avoid exceeding a certain heart or pulse rate to reduce unnecessary strain on their heart.
Most subjects that require continuous heart rate readings choose a monitor that requires a chest strap. Though they provide heart rates continuously, chest straps are cumbersome and generally undesirable to wear. In addition to chest strap solutions, portable patient monitors (e.g., vital signs monitors, fetal monitors) can perform measuring functions on subjects such as arrhythmia analysis, drug dose calculation, ECG waveforms cascades, and others. However, such monitors are usually fairly large and are attached to the subject through uncomfortable wires.
Pulse rate can be measured at the wrist. The shallow depth of the radial artery in the wrist offers a number of advantages for achieving continuous pulse detection at the wrist. Prior sensors that monitor pressure pulses in the wrist have not been effective. Pressure pulses are attenuated by the tissues between the artery and the sensor. Most of the high frequency signal components are lost because of the attenuation. Additionally, muscle movement may create substantial noise at the pressure sensors. The low frequency noise signals make it very difficult to reliably identify low frequency blood pressure pulses.
Ultrasonic monitors using sonar technology were developed to overcome noise signal problems. Ultrasonic monitors transmit ultrasonic energy as a pulse signal. When a power source drives a transducer element, such as a piezoelectric crystal, to generate the pulse signal, the ultrasonic pulse signal is generated in all directions, including the direction of the object to be measured such as a blood vessel. The portion of the ultrasonic pulse signal reaching the vessel is then reflected by the vessel. When the blood vessel experiences movement, such as an expansion due to blood flow from a heart contraction, the reflected pulse signal experiences a frequency shift, also known as the Doppler shift.
When either the source of an ultrasonic signal or the observer of the sonar signal is in motion, an apparent shift in frequency will result. This is known as the Doppler effect. If R is the distance from the ultrasonic monitor to the blood vessel, the total number of wavelengths λ contained in the two-way path between the ultrasonic monitor and the target is 2R/λ. The distance R and the wavelength λ are assumed to be measured in the same units. Since one wavelength corresponds to an angular excursion of 2π radians, the total angular excursion Φ made by the ultrasound wave during its transit to and from the blood vessel is 4πR/λ radians. When the blood vessel experiences movement, R and the phase Φ are continually changing. A change in Φ with respect to time is equal to a frequency. This is the Doppler angular frequency Wd, given by
      W    d    =            2      ⁢      π      ⁢                          ⁢              f        d              =                            ⅆ          Φ                          ⅆ          t                    =                                                  4              ⁢              π                        λ                    ⁢                                    ⅆ              R                                      ⅆ              t                                      =                              4            ⁢            π            ⁢                                                  ⁢                          V              r                                λ                    
where fd is the Doppler frequency shift and Vr is the relative (or radial) velocity of target with respect to the ultrasonic monitor.
The amount of the frequency shift is thus related to the speed of the moving object from which the signal reflects. Thus, for heart rate monitor applications, the flow rate or flow velocity of blood through a blood vessel is related to the amount of Doppler shift in the reflected signal.
A piezoelectric crystal may be used both as the power generator and the signal detector. In this case, the ultrasonic energy is emitted in a pulsed mode. The reflected signal is then received by the same crystal after the output power source is turned off. The time required to receive the reflected signal depends upon the distance between the source and the object. Using a single crystal to measure heart rates requires high speed power switching due to the short distance between source and object. In addition, muscle movement generates reflections that compromise the signal-to-noise-ratio in the system. The muscle movement noise has a frequency range similar to the frequency shift detected from blood vessel wall motion. Therefore, it is very difficult to determine heart rates with this method. The advantage of this approach, however, is low cost and low power consumption.
In some ultrasonic signal systems, two piezoelectric elements are used to continuously measure a pulse. The two elements can be positioned on a base plate at an angle to the direction of the blood. In continuous pulse rate measurement, the Doppler shift due to blood flow has a higher frequency than the shifts due to muscle artifacts or tissue movement. Therefore, it is more feasible to separate pulse signals from muscle artifacts using ultrasound Doppler technology than other methods such as pressure, infrared, RF and other sensing techniques. The disadvantages of continuous mode over pulsed mode are higher cost and more power consumption.
Although blood flow has a higher frequency shift than muscle artifacts for a subject at rest, this difference is minimized when a subject is exercising. When muscle mass moves at a higher speed, for example during exercise such as running, the frequency of the noise generated by the muscle mass is closer to the blood flow frequency. This is because the muscle mass may be moving at a similar speed as the blood flow. As a result, the muscle noise signal and blood flow signal will overlap in the same frequency band.
Most prior heart rate monitors determine a subject's heart rate by calculating a time period between two or more detected heart beats. When monitoring a subject, it can be difficult to determine the difference between a heart beat and noise which occurs within the body of the subject. When noise is mistaken for a heart beat, the heart rate calculated as a result of the noise becomes inaccurate. This problem is compounded when a subject being monitored is active, and the level and variations of noise increase within the subject due to increased activity. It would be advantageous to more accurately determine a heart rate within a subject.